2016-05-13T08:34:27-05:00 2015-06-30 GRANT THORNTON LLP 2001 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2014-07-01 520591531 Western MD Health System Corp Inc % WESTERN MARYLAND HEALTH SYST WEST 2409648003 PO BOX 539 CUMBERLAND MD 215010539 KIMBERLY S REPAC VP, CFO 2409648003 2016-05-13 true Frank Giardini P00532355 2155614200 2014 2016-12-15 16:53:06Z Kimberly S Repac PO BOX 539 CUMBERLAND MD 21501 408467877 false X WWW.WMHS.COM X 1905 MD WMHS is dedicated to providing patient- centered care and improving the health and well-being of people in the communities we serve. Please see Part III, line 1 for details. 10 7 2136 434 985874 -39654 1427840 1178880 381087796 389912971 4947417 -1104989 4882347 3789634 392345400 393776496 0 0 0 0 139041374 127012009 0 0 0 229888383 247738282 368929757 374750291 23415643 19026205 579856032 547596404 416565868 393076728 163290164 154519676 X WMHS is dedicated to providing patient-centered care and improving the health and well-being of people in the communities we serve. WMHS is helping to shape dynamic partnerships in advancing health and well-being. false false 226801168 266572146 ANCILLARY CARE WESTERN MARYLAND HEALTH SYSTEM (WMHS) OFFERS A COMPREHENSIVE RANGE OF GENERAL AND SPECIALTY SERVICES FOR PATIENTS. SURGICAL, LABORATORY, RADIOLOGY, CARDIOLOGY, CANCER, RESPIRATORY AND PULMONARY ARE THE LARGER SERVICES PROVIDED AT THE HOSPITAL. A SMALLER SCALE OF ANCILLARY SERVICES ARE PROVIDED AT THE NURSING HOME. 70486880 81928739 INPATIENT ROUTINE CARE WESTERN MARYLAND HEALTH SYSTEM (WMHS) IS A FULL SERVICE COMMUNITY HOSPITAL LICENSED FOR 225 BEDS INCLUDING MEDICAL-SURGICAL, INTENSIVE CARE, HIGH LEVEL CARE, OBSTETRIC, PEDIATRIC, PSYCHIATRIC REHABILITATION, NURSERY, AND 88 NURSING HOME BEDS. FOR THE YEAR, 12,823 PATIENTS WERE ADMITTED TO THE HOSPITAL AND FOR THE NURSING HOME, THE AVERAGE DAILY CENSUS WAS 84 PATIENTS. THE HEALTH SYSTEM ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THOSE PATIENTS WHO MEET CERTAIN CRITERIA UNDER WMHS'S CHARITY CARE POLICIES RECEIVE SERVICES AT NO CHARGE OR AT AN AMOUNT LESS THAN FULL CHARGES. 21664000 25180632 PHYSICIAN PRACTICES, CLINICS, AND HOME CARE WESTERN MARYLAND HEALTH SYSTEM (WMHS) OPERATES 13 PHYSICIAN PRACTICES, 2 URGENT CARE CLINICS, AND A HOME CARE PRACTICE. THE PHYSICIAN PRACTICES HAD 88,022 ENCOUNTERS; THE CLINICS HAD 16,827 ENCOUNTERS AND HOME CARE HAD 34,756 VISITS FOR THE YEAR. 15633623 18893749 Emergency Care 15633623 18893749 334585671 true true false false false false false false false true true false false true true true false true false true true false false false false false true true false false true true false false false false false false false false false true false false false false false true false false false true 102 0 true 2136 true true true true CJ false false false false false false false false X 10 7 true false false false false false false true true false false true true true true true true true true true true MD X WESTERN MARYLAND HEALTH SYST 2409648003 PO BOX 359 CUMBERLAND MD 21501 JOHN DAVIS Chairman 4.0 0.0 X X 0 0 0 ROLF HAARSTAD Vice Chair 4.0 0.0 X X 0 0 0 GREGG WOLFF MD Secretary 4.0 0.0 X X 0 0 0 Joyce Lapp Treasurer 4.0 0.0 X X 0 0 0 Keith Funkhouser Board Member (start may 2014) 3.0 0.0 X 0 0 0 Mary Ann Jenkins Board Member 3.0 0.0 X 0 0 0 Shiv Khanna MD Board Member 3.0 0.0 X 0 0 0 David C Mathews Board Member 3.0 0.0 X 0 0 0 SHARON NICOL Board Member 3.0 0.0 X 0 0 0 MARY PIROLOZZI Board Member 3.0 0.0 X 0 0 0 ELIZABETH HURWITZ-SCHWAB Board Member 3.0 0.0 X 0 0 0 Courtney Thomas Board Member 3.0 0.0 X 0 0 0 Richard Watro Board Member 3.0 0.0 X 0 0 0 Kimberly S repac VP, CFO 40.0 0.0 X 409939 0 39676 Nancy D Adams VP. COO/ CNE 40.0 0.0 X 349370 0 52978 Barry P Ronan President/ CEO 40.0 0.0 X 826946 0 89257 JO M WILSON VP, SUPPORT OPERATIONS 40.0 0.0 X 208414 0 41318 KEVIN R TURLEY VP, SUPPORT OPERATIONS 40.0 0.0 X 206710 0 42217 MICHELE R MARTZ VP, REVENUE CYCLE 40.0 0.0 X 208159 0 39864 WILLIAM BYERS VP, CIO 40.0 0.0 X 127968 0 21374 STEVEN R SMITH MD PHYSICIAN Enterprise Director 40.0 0.0 X 311750 0 51516 Jamie Karstetter VP,Patient Care (start 9/4/14) 40.0 0.0 X 121695 0 38392 Gerald Goldstein CMO (start 5/1/14) 40.0 0.0 X 249562 0 26286 MARK G NELSON MD PHYSICIAN 40.0 0.0 X 623382 0 69447 BLANCHE MAVROMATIS PHYSICIAN 40.0 0.0 X 521610 0 66287 CHRISTOPHER B HAAS MD PHYSICIAN 40.0 0.0 X 600054 0 59013 DALE E WOLFORD MD PHYSICIAN 40.0 0.0 X 625850 0 75256 DOUGLAS TICE PHYSICIAN 40.0 0.0 X 671961 0 74919 6063370 0 787800 85 false true false Haystack Imaging Services PO Box 539 CUMBERLAND MD 21502 Diagnostic 8048429 Pharmacare 3 Commerce Drive CUMBERLAND MD 21502 Pharmacy 4093328 Cumberland Anesthesia PO Box 1571 CUMBERLAND MD 21502 Anesthesia 2371430 Aramark 25271 Network Place CHICAGO IL 60673 Dietary 2230969 HMP of Maryland PO Box 645037 CINCINNATI OH 45264 Medical Svcs 1498968 43 414651 736063 28166 1178880 ANCILLARY CARE 621990 263909851 262933255 976596 INPATIENT ROUTINE CARE 621990 81928739 81928739 PHYSICIAN PRATICES, CLINICS & HOME CARE 621990 25180632 25180632 EMERGENCY CARE 621990 18893749 18893749 389912971 -1650514 9278 -1659792 0 0 810718 8300 668275 142443 8300 150743 150743 14568231 400 14023106 545125 400 545525 545525 0 0 0 CAFETERIA 621500 80240 80240 REIMBURSEMENT OF EXPENSES 621500 1284332 1284332 MISCELLANEOUS 621500 2274319 2274319 3638891 393776496 392575266 985874 -963524 0 0 0 0 3319531 3087164 232367 0 93353961 86819184 6534777 8221792 7646267 575525 15549895 14461402 1088493 6566830 6107152 459678 0 752760 752760 271000 271000 0 0 356313 356313 3177320 2954908 222412 394346 366742 27604 59399223 55241277 4157946 4643043 4318030 325013 0 4665122 4338563 326559 745383 693206 52177 0 0 13600680 13600680 0 25931794 24116568 1815226 3282466 3052694 229772 CONTRACTUAL/CHARITY 77306419 71894970 5411449 BAD DEBTS 6987888 6498736 489152 MEDICAL PROFESSIONAL FEES 10367964 9642206 725758 MINORITY INTEREST 2591658 2410242 181416 33264903 30936360 2328543 374750291 334585671 40164620 0 47802933 71641868 66695793 68336322 0 0 44050214 38839754 0 0 0 0 0 0 5752339 5971419 3771857 3606172 538527391 239366496 314130635 299160895 0 0 0 0 0 0 0 0 97652261 60039974 579856032 547596404 31601649 33255452 0 0 0 0 309780000 236170000 0 0 0 0 0 0 0 0 75184219 123651276 416565868 393076728 X 162868854 154201454 160871 58061 260439 260161 163290164 154519676 579856032 547596404 X 19026205 2160434 -29957127 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 355795 35000 -278 83913 306604 319428 96831 15676 76140 355795 720859 40000 3904 445335 319428 1567441 30000 -4723 871859 720859 2281205 94675 -755 807684 1567441 0.15000 0.85000 true false 7614249 7614249 333156532 82739098 250417434 190567846 154201356 36366490 7188764 2426042 4762722 299160895 FUNDS ON DEPOSIT WITH TRUSTEE 10340276 OTHER ACCOUNTS RECEIVABLE 5695127 A/R FROM AFFILIATES 2284294 IMPREST FUND - W/C 1064012 INVESTMENT - BOARD DESIGNATED 10075013 RESTRICTED BY DONOR 318222 INVESTMENT IN AFFILIATES 20064000 OTHER LONG TERM INVESTMENTS 7874345 UNDER BOND INDENTURE 2324685 60039974 0 FEDERAL INCOME TAXES 367 PAYABLES TO THIRD PARTY 6644289 BOND PREMIUM 32787700 DEFERRED COMP 834997 PROFESSIONAL INSURANCE 11603429 PENSION LIABILITY 70485849 LOAN PAYABLE HAYSTACK 1294645 123651276 X 311955000 311955000 356313 81465183 81821496 393776496 288177000 288177000 356313 86216978 86573291 374750291 ENDOWMENT FUNDS PART V LINE 4 Intended uses of the income from the pugh endowment fund are to provide free beds and free service to those who may become patients and who through financial inability may be unable to make provisions for their own medical and/or surgical relief. Anderson family foundation endowment fund is restricted for use to address hospital Acquired infections. OTHER REVENUES INCLUDED ON FORM 990 Part XI, Line 4b Contractual Allow $ 67,601,113 Charity $ 9,705,306 Bad Debt $ 6,987,888 Unrealized Gain $ (2,160,434) Rounding $ (415) Rental Exp $ (668,275) -------------- Total $ 81,465,183 OTHER EXPENSES INCLUDED ON FORM 990 Schedule D, Part XII, Line 4b Contractual Allow $ 67,601,113 Charity $ 9,705,306 Bad Debt $ 6,987,888 Minority Interest $ 2,591,658 Rounding $ (712) Rental Exp $ (668,275) ------------ Total $ 86,216,978 Liability for Uncertain Tax Positions (FIN 48 Footnote) Schedule D Part X The Health System and substantially all of its affiliates are exempt from federal income tax, except for unrelated business income, which is nonexistent, under Section 501(c)(3) of the Internal Revenue Code. Accordingly, no provision for income taxes is made in the consolidated financial statements for these entities. Central America and the Caribbean Program Services Insurance 1621934 1621934 1621934 true false true false false false true true X true X true X true true false true true 37950 9705306 9705306 0.02640 7835600 6700417 1135183 0.00310 37950 17540906 6700417 10840489 0.02950 123558 1111815 4224 1107591 0.00300 85201 991681 500 991181 0.00270 101669 44728665 22236674 22491991 0.06120 473 403291 12000 391291 0.00110 310901 47235452 22253398 24982054 0.06800 348851 64776358 28953815 35822543 0.09750 93303 44714 48589 0.00010 130211 130211 0.00040 927691 927691 0.00250 1151205 44714 1106491 0.00300 true 6987888 137268644 105682056 31586588 X true true Cumberland Propert Rental 1.00000 Johnson Heights Med Rental 0.83950 0.16050 Memorial Med Ctr Ser Building Maintenance 1.00000 Haystack Imaging Health Care 0.50000 0.50000 1 1 Western Md Regional Medical Center 12500 Willowbrook Road Cumberland MD 21502 www.wmhs.org. X X X WESTERN MD REGIONAL MEDICAL CENTER 1 false false true X X X X X X X X X X 13 true false false true X WWW.WMHS.COM X true 12 true WWW.WMHS.COM false false true X 200. 300. X X X X true true X X X true X 0 X X X X true X X false X X X true X false true SCHEDULE H, PART V, Section B, FACILITY INFORMATION COMMUNITY HEALTH NEEDS ASSESSMENT Line 3, Description Line 5, Persons Consulted The Allegany County Health Department and the Western Maryland Health System (WMHS) lead community health needs assessments efforts. The Allegany County Health Department works to promote health in Allegany County and WMHS is a Total Patient Revenue hospital and the only hospital in the county, providing a unique opportunity to impact community health. SCHEDULE H, PART V, Section B, FACILITY INFORMATION FINANCIAL ASSISTANCE POLICY, Line 22 WMHS determines the maximum amounts that can be charged to the Financial Assistance Policy ("FAP") eligible individuals by using HSCRC RATE ORDER and REGULATIONS. SCHEDULE H, PART V, Section B, FACILITY INFORMATION INDIVIDUALS ELIGIBLE FOR FINANCIAL ASSISTANCE, LINE 24 Maryland's regulatory system creates a unique process for hospital payment that differs from the rest of the nation. The Health Services Cost Review Commission (HSCRC) determines payment through a rate setting process and all payors, including government payors, pay the same amount for the same services delivered at the same hospital. In accordance with Maryland law, the Western Maryland Health System has a financial assistance policy and patients may be entitled to receive financial assistance with the cost of medically necessary hospital services if they have a low income, do not have insurance, or their insurance does not cover medically-necessary hospital care. WMHS also considers persons who do not meet the FAP income guidelines under expansion of the FAP policy for financial hardship that would limit the amount expected to be paid based on percentage of income. 1 Frostburg Nursing and Rehabilitation Ctr 48 Tarn Terrace Frostburg MD 21532 Nursing home SCHEDULE H, PART II COMMUNITY BUILDING ACTIVITIES Community Support - WMHS has in place a disaster readiness program. As the largest hospital in the area and the largest employer, WMHS has incurred costs to be able to deal with a disaster if the need arises. Coalition building - WMHS works with community partners to improve the health in the community. Education programs, screenings, and various other events are conducted by WMHS. Workforce development - WMHS is actively involved in the recruitment of physicians and other health professionals for the federally medical underserved area through a collaboration with regional partners. SCHEDULE H, PART III BAD DEBT EXPENSE, LINE 4 Bad debt expenses are for those services rendered to patients who have been determined to have the financial capacity, but are unwilling to pay. The total expense is write-offs, made after following the provisions of the hospital's collection and write-off policy, less bad debt recoveries. An estimate of the amount of charity care attributable to patients who likely would qualify for financial assistance under the hospital's charity care policy, if sufficient information was available to make a determination of their eligibility, is based upon a review of records of patients who had accounts written off. WMHS has an audit of its financial statements prepared. The community benefits amount shown in Schedule H - Part I do not include bad debt expense. SCHEDULE H, PART III SECTION B MEDICARE LINE 8, COSTING METHODOLOGY Cost to charge ratio. SCHEDULE H, PART III SECTION C COLLECTION PRACTICES, LINE 9B - The Western Maryland Health System provides care to all patients seeking care, regardless of their ability to pay. A patient's ability to pay is based on a review which is done by a member of the Health System's Business Office. This review assures that all patients who seek emergency or urgent care receive those services regardless of the patient's ability to pay. -In accordance with Maryland law, the Western Maryland Health System has a financial assistance policy and patients may be entitled to receive financial assistance with the cost of medically necessary hospital services if they have a low income, do not have insurance, or their insurance does not cover medically-necessary hospital care. -The Western Maryland Health System meets or exceeds the state's legal requirement by providing financial assistance based on income established by and published by the Federal Government each year. -Those patients that meet the financial assistance policy criteria described above may receive assistance from the Health System in paying their bill. If a patient believes he has wrongly been referred to a collection agency, he has the right to contact the hospital to request assistance. WMHS adjusted its policies and practices to meet all 501r requirements as of March 2016. Schedule H Part VI- Supplemental Information Community Health Needs Assessment The Community Health Needs Assessment is completed every three years. The latest plan was updated in 2014. The Allegany County Health Department and Western Maryland Health System is responsible for facilitating the needs assessment process. Allegany County is located in rural Western Maryland with a population of 75,087. It is part of the Appalachian region and has low education levels, limited racial diversity , a large elderly population and low household incomes. Allegany county and its service providers are impacted by being a tri-state region which includes Pennsylvania and West Virginia. WMHS serves 7 counties in 3 states. The process involves the review of the 13 priority areas that were identified in the previous CHNA as well as SHIP updates for the county. Problem areas and trends identified through County Health Rankings and Community Commons are also reviewed. In the review both health status indicators and causative factors are considered. Data sources from the last needs assessment are reviewed and utilized to clarify issues. Areas focused on are Cancer Profiles, to ten reasons for ED visits and Hospital admissions, Core Measures, Workforce Development Plan, Transportation Survey and Network of care are all reviewed and changes and trends are identified. The magnitude, severity and level of need for the most vulnerable populations, are taken into consideration to list the most prevalent community health needs. The data was sorted under three main themes: access, healthy lifestyles and wellbeing, and disease management to allow for consideration of both outcomes and root causes. There were 18 identified needs and associated data looked at along with information regarding health status indicators, causative factors and trends which were discussed with the coalition, and focus group with various community organization and residents. Input from the community was asked and received as to what they thought would work in the community. The 18 areas of focus centered around Children in Poverty, Primary Care Assess, Dental Access, Health Literacy, Homelessness, Smoking, Physical Inactivity, Healthy Weight, Domestic Violence, Fall Related ED visits, Behavioral Health, Diabetes, Heart Disease, Hypertension, and Asthma. The identified Health needs for FY15-17 were identified in order of priority under the three categories as follows: Access and Socio Economics: Children in Poverty, Primary Care access, Adult Dental Access, Health Literacy and Homelessness. Healthy Lifestyles and Wellbeing: Smoking, Physical Inactivity, Healthy Weight, Domestic Violence and Fall related injury and death. Disease Management: Behavioral Health, Diabetes, Heart Disease, Hypertension and Asthma SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE, LINE 3 Western Maryland Health System is committed to providing financial assistance to persons who have health care needs and are uninsured, underinsured, ineligible for a government program, or otherwise unable to pay, for medically necessary care based on their individual situation. A patient can qualify for Financial Assistance either through lack of sufficient insurance or financial hardship due to excessive medical debt. It is the policy of WMHS to provide Financial Assistance based on indigence or excessive medical debt for patients who meet specified financial criteria and request such assistance. WMHS will post notices of availability at patient registration sites, Admissions, Business Office and at the Emergency Department. Notice of availability will also be sent to patients on patient bill statements. A Patient Billing and Financial Assistance Information Sheet will be provided to inpatients via the Admission Handbook given to every admitted patient. This is provided to patients prior to discharge and is also available to all patients upon request. SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION COMMUNITY INFORMATION, LINE 4 WMHS provides primary and secondary acute care services for a seven county region covering the Upper Potomac region of Maryland, Eastern West Virginia and Southwestern Pennsylvania. With 72% of the patients residing in Allegany County, Maryland, WMHS considers this community its Community Benefit Service Area. SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION PROMOTION OF COMMUNITY HEALTH, LINE 5 SEE COMMUNITY BENEFIT SUMMARY IN SCHEDULE O. SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION AFFILIATED HEALTH CARE SYSTEM, LINE 6 -SETON REGIONAL HEALTH SYSTEM (EIN: 52-1333566), TAX EXEMPT UNDER 501(c)(3), PUBLIC CHARITY STATUS 11 TYPE I, CHARITABLE -WMHS FOUNDATION (EIN: 35-2289841), TAX EXEMPT UNDER 501(c)(3), PUBLIC CHARITY STATUS 11 TYPE I, FUNDRAISING -MEMORIAL MEDICAL CENTER SERVICES (EIN: 52-1317704), C CORPORATION, BUILDING MAINTENANCE -WILLOWBROOK HC CONDO (37-1538510), C CORPORATION, CONDO MANAGEMENT -HAYSTACK CONSOLIDATED (52-1335895), C CORPORATION, MEDICAL SERVICES -WESTERN MD MEDICAL SUPPLY (26-0119241), C CORPORATION, MEDICAL SUPPLY SALES SCHEDULE H, PART VI SUPPLEMENTAL INFORMATION STATE FILING OF COMMUNITY BENEFIT REPORT, LINE 7 WMHS files a community benefit report with the Maryland Health Services Cost Review Commission (HSCRC). X X X X X X false true false false false false false true false Kimberly S repac VP, CFO 345939 0 64000 0 0 0 35671 0 4005 0 449615 0 0 0 Nancy D Adams VP. COO/ CNE 295370 0 54000 0 0 0 32386 0 20592 0 402348 0 0 0 JO M WILSON VP, SUPPORT OPERATIONS 182464 0 25950 0 0 0 20346 0 20972 0 249732 0 0 0 KEVIN R TURLEY VP, SUPPORT OPERATIONS 181060 0 25650 0 0 0 20228 0 21989 0 248927 0 0 0 Barry P Ronan President/ CEO 573650 0 253296 0 0 0 65762 0 23495 0 916203 0 0 0 MICHELE R MARTZ VP, REVENUE CYCLE 183109 0 25050 0 0 0 19904 0 19960 0 248023 0 0 0 MARK G NELSON MD PHYSICIAN 623382 0 0 0 0 0 51226 0 18221 0 692829 0 0 0 BLANCHE MAVROMATIS PHYSICIAN 422779 0 98831 0 0 0 44421 0 21866 0 587897 0 0 0 CHRISTOPHER B HAAS MD PHYSICIAN 540054 0 60000 0 0 0 49648 0 9365 0 659067 0 0 0 DALE E WOLFORD MD PHYSICIAN 396685 0 229165 0 0 0 51662 0 23594 0 701106 0 0 0 STEVEN R SMITH MD PHYSICIAN Enterprise Director 281750 0 30000 0 0 0 29615 0 21901 0 363266 0 0 0 DOUGLAS TICE PHYSICIAN 621961 0 50000 0 0 0 54820 0 20099 0 746880 0 0 0 Jamie Karstetter VP,Patient Care (start 9/4/14) 121695 0 0 0 0 0 12815 0 25577 0 160087 0 0 0 Gerald Goldstein CMO (start 5/1/14) 220393 0 29169 0 0 0 18229 0 8057 0 275848 0 0 0 SUPPLEMENTAL NON-QUALIFIED RETIRMENT PLAN SCHEDULE J, LINE 4B AND LINE 7 Barry P. Ronan received a SERP payout in the amount of $107,296. A MHHEFA 520936091 574217zya 2006-11-14 348650000 Replace Hospital Facility true false false B MHHEFA 520591531 574218sp9 2014-11-19 236170000 REPLACE HOSPITAL FACILITY false false false A 43045000 305605000 348650000 0 39097063 322084350 0 0 0 292400179 0 0 2009 false true true true B 2900000 0 236170000 0 0 0 2324685 0 0 0 0 0 false true true true A false true true true true true 0.02700 0.00220 0.02920 true false false true B false true true true true true 0.02700 0.00000 0.02700 false false true A false true false true false false 0 true wachovia securities 30. true false true B false true false true false false 0 true 0 A true B Part IV Arbitrage, Line 2c REBATE COMPUTATION WAS PERFORMED NOVEMBER 15, 2010. KIMBERLY S REPAC SR. VP CFO 20201504 MD PHYSICIAN CARE false BARRY P RONAN PRESIDENT & CEO 20201504 MD PHYSICIAN CARE false BUSINESS TRANSACTIONS WITH INTERESTED PERSONS SCHEDULE L PART IV These transactions represent the monetary value of business transactions between MD Physicians Care and Western Maryland Health System. Creation of triverent health alliance mso, llc Form 990, Part III, Line 2 WMHS, Meritus Health System and Frederick Memorial Hospital created Trivergent Health Alliance MSO, LLC a Maryland limited liability company to perform on a cooperative basis, the hospitals to aggregate their efforts and expenditures to achieve cost savings, lower health care costs, create other efficiencies for the hospitals and improve the quality of care. The initial service categories include Revenue Cycle, Lab management services, Supply chain, Human Resources, IT services and Pharmacy management services. The organization was formed in July 2014. The three health Systems also created Trivergent Health Alliance LLC which is the parent company to the MSO whose focus also includes Population Health Initiatives and Clinical integration activities. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D EMERGENCY CARE Western Maryland Health System (WMHS) operates a 24-hour/7-day-a-week emergency room which serves as the designated area-wide trauma center. 52,331 visits were registered in the emergency room for the year ending June 30, 2015. Officers and Trustees Business Relationships Form 990, Part VI, SECTION A, Line 2 Michele R. Martz (Key Employee) serves on the Board of the United Way of the Potomac Highlands of which Mary Beth Pirolozzi (Trustee) is the Executive Director. Kevin Turley (Key Employee) serves on the board and executive committee of HDRC of which Courtney Thomas (trustee) is the executive director. Form 990 Governing Body Review FORM 990, Part VI, SECTION B, Line 11 On an annual basis, the Executive Committee of the Board of Directors meets to review IRS Form 990 and 990T before it is filed with the Internal Revenue Service. The Chief Financial Officer (CFO) presents an executive summary and then provides a detailed review and explanation of each form. Any open items or questions are resolved prior to the filing of the form. Subsequent to its review, the Executive Committee reports back to the Board regarding its oversight of the Form 990. The board is informed that a complete copy of the Form 990 is available on the board's secure password protected web site. Conflict of Interest Policy Compliance FORM 990, Part VI, SECTION B, Line 12c The WMHS Board of Directors monitors proposed or ongoing transactions for conflicts of interest and addresses any potential or actual conflicts. Pursuant to the Conflicts of Interest Policy, an annual conflict questionnaire is distributed to all interested persons. Interested persons are required to disclose real or potential conflicts at the time when such conflicts arise. When one becomes an interested person and annually thereafter, they are required to sign a statement affirming that they have received, read, understand, and agree to comply with the policy. The completed questionnaires are reviewed by the Board. The procedures for addressing any conflict include the conflict being fully disclosed and discussed with the interested person along with the potential resolutions of the conflict. Process for Determining Compensation FORM 990, Part VI, SECTION B, Line 15a & 15b The Board appoints a Compensation Committee of independent directors without a conflict of interest with respect to the compensation arrangement, responsible for setting reasonable compensation packages for each officer or key employee, including the CEO. The Committee develops, consistent with organizational philosophy and principle, the annual performance goals and criteria to be used in determining merit increases and variable compensation. The Committee also hires an independent compensation and benefits specialist to review, analyze and provide benchmarking data for the total compensation and benefits packages. Comparability data is obtained for similar job responsibilities. Written records of all analyses are maintained to support decisions related to key employees and officers. Availability of Governing Documents to Public FORM 990, Part VI, SECTION C, Line 19 While the federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection, the organization makes its financial statements available upon request. In Maryland, the organization's financial statements are also submitted to the Health Services Cost Review Commission which is available for public inspection as well. Other Changes in Net Assets or Fund Balances Part XI Line 9 Minimum Pension Liability Adjustment $(30,076,000) Transfer to Operations (83,913) Income Released from Restricted $221,960 Restricted Donations 35,000 Caring Fund 6/30/2014 (53,987) Unrealized Gain (278) Rounding 90 ------------ Total $(29,957,128) ============= Schedule H - Community Benefit Summary Form 990, Part V, Section C - 1st The Allegany County Health Department and the Western Maryland Health System (WMHS) lead community health needs assessments efforts. The Allegany County Health Department works to promote health in Allegany County and WMHS is a Total Patient Revenue hospital and the only hospital in the county, providing a unique opportunity to impact community health. Form 990, Part V, Section C - 2nd The data collected as part of the Community Health Needs Assessment is shared with the WMHS Administrative Team and Board of Directors. This information along with other hospital data and information was utilized to create the hospital's strategic plan. The following are sections of the strategic plan that apply to community benefits. Strategic Plan FY 2015-2017 Goal 2. Expand patient centered care delivery model Objective 2.1. Further develop and strengthen strategic relationships with community partners Objective 2.1.1. Further develop medical and public health Proposed tactics: a. Consider and evaluate more formal arrangements with county health departments, i.e. joint venture b. Coordinate with public health agencies to inventory program services to identify opportunities for improvement through collaboration c. Develop and implement action plan based on analysis Strategy 2.1.2 Develop the network with community agencies to address social determinants and transitions of care Proposed tactics: a. Establish an advisory council for Community Health Workers throughout the community b. Develop an assessment tool for patient use at registration and work with community partners to establish a referral system utilizing available resources to address social determinants c. Identify community partners to engage in a process review and pilot implementation of interagency management of individuals with multiple chronic conditions d. With agencies such as HRDC and the YMCA create a comprehensive asset map for the community identifying services for the underserved, areas of duplication, as well as gaps e. Work with a diverse advisory group (or CUW) to address duplication and/or gaps identified Goal 3. Engage patients and families to improve personal health status Objective 3.2 Enhance patient and family participation in care Strategy 3.2.1 Develop and implement consumer driven health initiatives to enhance patient and family engagement Possible Tactics: a. Collaborate with community partners to develop and implement an "is it safe to wait" program to promote a consistent message on when to go to the Emergency Department, urgent care or primary care b. Review the findings on self-care programs with the President's Quality Council, and if supported, form a team to develop a pilot proposal to consider for implementation c. Research and determine how consumers want to access health information, test results, as well as communicate with their providers. Compile results with a summary of recommendations to consider for potential implementation Strategy 3.2.2 Revitalize an external patient transportation program for WMHS Goal 4. Coordinate care to provide comprehensive population health management Objective 4.1 Expand pre and post-acute services to reduce utilization of care Strategy 4.1.3 Further expand the service offerings at the Center for Clinical Resources to include services for hypertension, chronic kidney disease, et. WMHS provided a net community benefit of $36,954,026 to the community, Which included Unreimbursed Medicaid costs, Community health services, health professions education, Mission driven health services, community building activities, cash and in-kind contributions, community benefit operations and charity care. 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